Prognostic value of postoperative adjuvant chemotherapy in patients with cervical and upper thoracic esophageal squamous cell carcinoma
- VernacularTitle:颈段和胸上段食管鳞状细胞癌术后辅助化疗的预后意义
- Author:
Kang GUO
1
,
2
,
3
;
Jie MA
4
,
5
;
Jianfei ZHU
4
,
5
;
Junfeng BAI
1
,
2
,
3
;
Wuping WANG
1
,
2
,
3
;
Qiang LU
4
,
5
;
Jinbo ZHAO
4
,
5
;
Xiaolong YAN
4
,
5
;
Jian WANG
4
,
5
;
Wenhai LI
1
,
2
,
3
;
Xiaofei LI
1
,
2
,
3
Author Information
1. Chest Hospital, Xi'
2. an International Medical Center Hospital, Xi'
3. an, 710100, P. R. China
4. Department of Thoracic Surgery, Tangdu Hospital, Air Force Military Medical University, Xi'
5. an, 710038, P. R. China
- Publication Type:Journal Article
- Keywords:
Cervical esophageal squamous cell carcinoma;
upper thoracic esophageal squamous cell carcinoma;
operation;
adjuvant chemotherapy;
prognosis
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2022;29(12):1580-1586
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore whether surgery combined with adjuvant chemotherapy can bring survival benefits to patients with cervical and upper thoracic esophageal squamous cell carcinoma (ESCC). Methods The clinical data of patients with cervical and upper thoracic ESCC who underwent R0 resection and neck anastomosis in our department from 2006 to 2010 were retrospectively analyzed. Patients received neoadjuvant therapy or adjuvant radiotherapy were excluded. The adjuvant chemotherapy group was given a combination of taxanes and platinum based chemotherapy after surgery; the surgery alone group did not receive adjuvant chemotherapy. The Kaplan-Meier method was used to analyze the survival difference between the adjuvant chemotherapy group and the surgery alone group. Results A total of 181 patients were enrolled, including 141 (77.9%) males and 40 (22.1%) females, with an average age of 61.0±8.2 years (80 patients aged≤61 years, 101 patients aged>61 years). There were 70 (38.7%) patients of cervical ESCC, and 111 (61.3%) patients of upper thoracic ESCC. Eighty-seven (48.1%) patients underwent postoperative adjuvant chemotherapy, and 94 (51.9%) patients underwent surgery alone, and the basic clinical characteristics were well balanced between the two groups (P>0.05). The median survival time of patients in the adjuvant chemotherapy group and the surgery alone group was 31.93 months and 26.07 months, and the 5-year survival rate was 35.0% and 32.0%, respectively (P=0.227). There was no statistical difference in median survival time between the cervical ESCC and upper thoracic ESCC group (31.83 months vs. 29.76 months, P=0.763). For cervical ESCC patients, the median survival time was 45.07 months in the adjuvant chemotherapy group and 14.70 months in the surgery alone group (P=0.074). Further analysis showed that the median survival time of lymph node negative group was 32.53 months, and the lymph node positive group was 24.57 months (P=0.356). The median survival time was 30.43 months in the lymph-node positive group with adjuvant chemotherapy and 17.77 months in the lymph-node positive group with surgery alone. The survival curve showed a trend of difference, but the difference was not statistically significant (P=0.557). Conclusion There is no statistical difference in the long-term survival of cervical and upper thoracic ESCC patients after R0 resection. Postoperative adjuvant chemotherapy may have survival benefits for patients with cervical ESCC and upper ESCC with postoperative positive lymph nodes, but the differences are not statistically significant in this setting.
